2002年广州地区淋球菌对4种抗生素耐药性结果分析

目的了解广州地区2002年淋球菌对抗生素的耐药性及产青霉素酶淋球菌(PPNG)和高水平耐四环素淋球菌(TRNG)的流行状况。方法用琼脂稀释法测定四环素、壮观霉素、头孢三嗪和环丙沙星4种抗生素对100株淋球菌的最低抑菌浓度(MIC)及用纸片碘量法检测β-内酰胺酶。结果100株淋球菌检出PPNG 15株(15%)、TRNG 28株(28%),环丙沙星耐药率高达98%,高度耐药株(MIC≥16 mg/L)32株(32%),未发现对头孢三嗪、壮观霉素的耐药菌株,但头孢三嗪的敏感性有所下降。结论目前广州地区流行的淋球菌菌珠耐药状况仍然严重,尤以环丙沙星为甚,但对壮观霉素和头孢三嗪仍较敏感。此外,有必要持续监测球菌的耐药性。     

单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1的研究

目的:探讨单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1(IRS-1)表达的改变。方法:对20例单纯性肥胖儿童,20例2型糖尿病儿童及20例对照组儿童,采用细胞免疫技术进行白细胞染色,运用图像分析软件计算光密度值,从而定量分析白细胞中IRS-1的含量变化。结果:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,且与对照组相比有统计学意义(P<0.05)。结论:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,与对照组相比有统计学意义(P<0.05),提示肥胖组与2型糖尿病组儿童胰岛素信号传递中受体后作用的关键底物缺陷,影响了胰岛作用的发挥。提示IRS-1与胰岛素抵抗有关,有利于进一步理解2型糖尿病的发病机制,指导临床治疗。     

卵巢癌中蛋白激酶C的表达及其临床意义

目的　探讨上皮性卵巢癌组织蛋白激酶C (proteinkinaseC ,PKC)的表达和化疗耐药的关系 ,以及与P -糖蛋白 (P -gp)的相关性。方法　用免疫组化S -P法检测 35例卵巢上皮性肿瘤组织、 2 0例卵巢良性肿瘤组织和 2 0例正常卵巢组织中PKC和P -gp的表达 ,并进行相关临床因素分析。结果　①PKC、P -gp在卵巢恶性肿瘤中的表达明显高于在良性及正常组织中的表达 ;并且PKC和P -gp的表达有相关性 (P <0 0 5 ) ;②卵巢癌PKC的表达与临床病理因素无直接关系 ;③恶性肿瘤中 ,初治和复发的PKC表达阳性率分别为 34 8%和 75 % ;④化疗对PKC表达阳性和阴性卵巢癌患者的有效率分别为 2 3 5 %、 6 6 7% (P <0 0 5 ) ;⑤PKC表达阴性患者的预后优于阳性者 (P =0 0 39)。结论　PKC表达与卵巢癌组织化疗耐药明显相关 ,可能在P -gp介导的卵巢癌多药耐药中起重要作用。     

医院感染常见细菌分布与耐药性分析

目的了解细菌分布及常见细菌的耐药性。方法回顾性分析某院2000—2004年临床标本分离的细菌及其耐药性监测结果。结果1439株细菌中，革兰阳性菌456株（31．69％），以凝固酶阴性表皮葡萄球菌为多，达206株（45．18％），其次为金黄色葡萄球菌92株（20．18％）；两种葡萄球菌的耐药率相似，对万古霉素耐药率均为0。革兰阴性菌983株，前5位依次为肠杆菌属346株（35．20％），克雷伯菌属164株（16，68％），铜绿假单胞菌155株（15．77％），埃希菌属101株（10．27％），变形杆菌属94株（9．56％）；前5位革兰阴性菌对常用抗菌药物的耐药性以半合成青霉索较明显，铜绿假单胞菌的耐药性较突出。结论应高度重视细菌变迁和耐药性监测，提高抗菌药物合理应用水平。     

Captopril and time dependent changes in post- to pre-glomerular resistance ratios in remnant kidneys of pre-hypertensive rats

Wilke , W. Lee & Person , A. E. G. 1992. Captopril and time dependent changes in post- to pre-glomerular resistance ratios in remnant kidneys of pre-hypertensive rats. Acta Physiol Scand 144 , 253–261. Received 26 June 1991, accepted 8 October 1991. ISSN 0001–6772. Department of Physiology, Colorado State University, Fort Collins, Colorado, USA and Department of Physiology and Biophysics, University of Lund, Sweden. Micropuncture experiments were performed on intact and remnant kidneys of male Sprague-Dawley rats before and after angiotensin converting enzyme inhibition with captopril (0.5 mg kg^-1 iv). Partially nephrectomized rats were studied at 2 and 8 weeks post-surgery before the development of systemic hypertension. At 2 weeks, nephrectomized rats had a numerically higher tubular stop-flow pressure than controls (43 ± 2 mmHg vs. 38 ± 2 mmHg; P = 0.08) and a higher post- to pre-glomerular resistance ratio (Re/Ra) (0.40 ± 0.03 vs. 0.31± 0.03; P = 0.08). At 8 weeks, stop-flow pressure and post- to pre-glomerular resistance ratios were similar in remnant and intact kidneys. Captopril had no effect on stop-flow pressure in 2 week post-surgery nephrectomized rats or either control group, but it increased stop-flow pressure in 8 week post-surgery nephrectomized rats (40 ± 2 to 44 ± 2 mmHg, P= 0.04). This increase in stop-flow pressure was associated with an increase in the post- to pre-glomerular resistance ratio (0.33 ± 0.02–0.42 ±0.02, P = 0.009). Stop-flow pressure was positively correlated with the post- to pre-glomerular resistance ratio in 2-week post-surgery nephrectomized rats and their respective controls when combined (r = 0.89, P= 0.0001) and 8-week post-surgery nephrectomized rats and their respective controls combined (r= 0.78, P = 0.0001). Stop-flow pressure was not significantly correlated with mean arterial pressures or welling-point pressures in these groups. We conclude that stop-flow pressure in remnant kidneys of pre-hypertensive rats is primarily determined by the post- to pre-glomerular resistance ratio, and increases in stop-flow pressure and post- to pre-glomerular resistance ratios in remnant kidneys are transient in the absence of systemic hypertension. The role of the renin-angiotensin system in determining the ratio and stop-flow pressure is dependent on time post-nephrectomy. Captopril-induced increases in stop-flow pressure and post- to pre-glomerular resistance ratio at 8 weeks, suggests that its primary effect at that time is not a preferential post-gIomerular vasodilation subsequent to reductions in intrarenal angiotensin II.     

老年患者尿路感染菌群分布及其耐药性分析

目的 :了解老年患者尿路感染致病菌的菌群分布及其对抗生素的耐药情况 ,为临床合理使用抗生素提供依据。方法 :收集湖北省 15所三级甲等医院 2 0 0 2年尿路感染老年患者清洁中段尿细菌培养分离的 5 34株致病菌 ,对其进行耐药性监测。药敏采用K B法 ,用WHONET 5软件进行数据分析。结果 :共收集致病菌 5 34株 ,其中革兰阴性菌 4 0 9株 (76 .6 % ) ,革兰阳性菌 12 5株(2 3.4 % )。革兰阴性菌中大肠埃希菌检出率最高 (2 6 4株 ,4 9.4 % ) ,其次为克雷白杆菌 (44株 ,8.2 % )。 16 .7%的大肠埃希菌和 2 2 .7%的克雷白杆菌产超广谱 β 内酰胺酶。亚胺培南、阿米卡星、头孢他啶对革兰阴性菌的抗菌活性最强 ,而革兰阴性菌对环丙沙星、庆大霉素、哌拉西林的耐药率均在 5 0 %以上。革兰阳性菌以肠球菌最多见 (6 4株 ,12 % ) ,其次为葡萄球菌属 (43株 ,8.1% )。革兰阳性菌对SMZco、红霉素等的耐药率均在 4 0 %以上 ,但对万古霉素均敏感。结论 :老年患者尿路感染以革兰阴性菌为优势菌株 ,且耐药性日益严重 ,对亚胺培南、阿米卡星、头孢他啶最为敏感。革兰阳性菌宜以万古霉素为首选。     

Comparison of redox and D29 phage methods for detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis

Rapid, accurate and inexpensive methods are essential to detect drug-resistant Mycobacterium tuberculosis and allow timely application of effective treatment and precautions to prevent transmission. The proportion method, the MTT and Alamar Blue redox methods, and the D29 mycobacteriophage assay, were compared for their ability to detect resistance to isoniazid and rifampicin. When tested against a panel of known M. tuberculosis strains, the redox methods and the D29 assay showed good sensitivity and specificity compared to the proportion method, suggesting that they could be useful alternatives for identifying multidrug resistance in M. tuberculosis.     

PCR-SSCP法检测结核分枝杆菌耐药性

目的：探讨耐多药结核分枝杆菌耐药基因突变与耐药性的关系以及聚合酶链反应-单链构象多态性分析(poly merase chain reaction-single strand cinfomlation polymorphism，PCR-SSCP)方法的临床应用价值。方法：用PCR-SSCP方法检测58株结核分枝杆菌临床分离株katG，rpoB，rpsL基因突变并与常规药敏试验检测结果进行对比。结果：经常规药敏试验检测，58株结核分枝杆菌临床分离株中共有41株耐药，其中，耐异烟肼(INH)为35株，高耐药株27株；耐利福平(RFP)为31株，高耐药株24株；耐链霉素(SM)有31株，高耐药株26株。同时耐3种药物的有21株(51．2％)，耐2种药物的14株(34．1％)，单耐药株6株(14．6％)．PCR-SSCP方法对58株临床分离株katG，rpoB，rpsL基因突变的检测率为40％(23／58)，45％(26／58)，38％(22／58)，其中检出3个基因同时突变的有13株(32％)，2种基因突变的12株(29％)，1种基因突变的有10株(23．8％)．常规药敏试验与PCR-SSCP法检出结核分枝杆菌同时耐3种药物的符合率为61．9％(13／21)，检出耐2种药物的符合率为85．70k，(12／14)，检出耐1种药物的符合率为50％(3／6)．高耐药株中突变率为80．5％(62／77)，低耐药株中突变率为60％(12／20)．结论：PCR-SS-CP方法对耐2种以上药物的结核杆菌检出率较高，且耐药基因突变率随着耐药浓度增高而增高。将PCR-SSCP法与药敏试验联合应用可互相弥补，已成为临床指导用药的好方法。